Readers' comments

even now the administration doesn't address how many are actually paying for the insurance coupled with the fact we know there's a large number that errantly signed up. So again 3+ years later whats the truth?

ACA does not patch the big loophole - don't buy insurance, buy consumables and things safe from bankruptcy. If you get sick negotiate a partial payment deal with the hospital and if real sick just run down your (non-existent)savings and go on Medicaid. The difference is that now no hospital is going to negotiate. ACA pretty much guarantees that there are no people who cannot get insurance, just people who choose to buy other stuff instead. This is not going to be pretty.

The outcome, as it is evolving, is certainly a major disappointment to Ms Howard, the author and an outspoken advocate of Obama's policies. But her perspective has blinded her to some of the realities. ObamaCare was structured around the premise that non-participants in insurance could be convinced or coerced into purchasing insurance plans that was not in their financial interest to purchase. They would be forced to buy expensive plans as a tax, to provide revenue to support the subsidy of other insurance plans. That was the plan, as documented by Obama's lawyers in their defense of the constitutionality of ObamaCare to SCOTUS. Unfortunately for Ms. Howard and Obama, this group is not made up of the dupes they were expected to be and they are refusing to pay this regressive tax that they have been unfairly burdened with. Ms. Howard, in her appeal for more dupes, completely neglects this reality.

I am relatively healthy. I qualified for major subsidy so having my insurance mostly paid for by the government is nice. Due to various factors, there is some chance I'll have to repay the subsidy with penalty and interest. A greater worry is this: the law(s) change frequently. It's bad enough that all these waivers are done -- so much for planning. If Obamacare is repealed in the future (I'd say that is a good possibility) what happens to people like me who in the past could not get [affordable] insurance? My guess is it will be back to the old game.

Not the government...your fellow citizens will be footing the bill. Your guess is probably correct. If you think healthcare is expensive now, wait until it is free. There are people who actually believe in the free lunch.

Who cares if you have insurance if the policy sucks? My family now has a $10,000 deductible ($2500 each) and a potential for $5000 per person total out of pocket expense. PER YEAR! This means I have to bank away at least $10k for a rainy day in a savings acct that pays no interest. Tell me a family on the edge can do this.

Before ACA, expense was just one isssue. Before, there was recission, denial of coverage etc.
.
I can tell you from direct and indirect experience that the medical system screws up regularly. The numbers of hideous screw ups for friends and family has reached the half dozen mark, which just suggests the problem is wide spread and common.
.
Our system is expensive and bad.
.
That point enrages me the most.

Why sign up when the premiums are guaranteed to go up year after year while deductibles do the same? Osamacare took a deeply flawed system, made a few small tweeks and made it mandatory. And woe unto thee who dares decline to participate in this fleecing. Defy the health insurance cabal and be thrown into the lake of fire. Selah!

What would our great country do without infallibly objective and scholarly patriots like yourself, comparing our president with the guy who masterminded the most horrific terrorist attack ever perpetrated upon the American people?

What no one is dealing with is this fact. The uninsured ARE covered. They just aren't paying for it.

The "success" of the free market and the advertising industry has left a large share of Americans with few assets and few prospects.

If they are not sick, they see no need of health insurance. Just as they see no need of saving for retirement or a downpayment. Because doing so would cost too much, relative to their real and engineered needs.

When they get sick, they will quickly become poor enough to quality for Medicaid, because the huge cost of health care would immediately make them "medically needy."

If their own state doesn't provide enough Medicaid benefits to meet their needs, it will surely provide a bus ticket to New York, where the Greater New York Hospital Association will be happy to do the paperwork to get them declared a local resident. Passing off one quarter of the bill to NYC taxpayers and one quarter to NY State taxpayers (including those to NYC).

Now if the federal government were to say "what you could have been insured but didn't pay? Sorry, no Medicaid. An thus no treatment for heart disease, diabetes or cancer," then this might change. As it is now, illness seems far away. And that ad for McDonalds is on TV. And the job pays $12.00 per hour with no benefits after 20 years experience.

I agree...it should be a national system. In fact, the federal government should take over all funding for unemployment insurance, Medicaid, any program that directs resources direct to people, for exactly that reason. They move between states.

To pay for it, it could cut off all funding for infrastructure, housing, "economic development projects," and a whole bunch of other stuff that stays were it is. Including the elimination of tax-based subsidies, like the mortgage interest deduction. States and localities would pay for their own.

Some way that the way things are going, we are heading for a 100 percent entitlement, defense and interest budget. I say bring it on. With the exception of defense, those things are locked in by formula, so there can't be different deals for different people. The ongoing political decisions would be localized.

Obama has lived up to his resume. This was his first real job, his first exposure to administration, management, and coalition building. Most Presidents get decades of experience with that sort of thing before we give them the White House.

‘Most recently, the White House announced that for two more years, Americans will be able to keep insurance that does not comply with Obamacare.’

Could any of Obamacare defenders (if such an entity still exists) explain how a future Republican president won’t be similarly empowered to unilaterally further delay enforcement of a multitude of the law’s provisions? Just want to make sure the left realizes that this entire healthcare charade will be for naught if the GOP takes the White House in 2016 solely due to the precedent Obama has set. So if it happens, we shouldn’t expect to hear any complaints because such behavior is above board, right?

You make a valid point, ParksDept. Then again, this is why it matters who is President, doesn't it? If all Presidents enforced the laws Congress passes in the same manner then we probably wouldn't get so worked up about who controls the executive branch...

Bush spent most of his 8 years making a mockery of our nation's environmental laws, so I doubt Democrats expect anything different from the next Republican President.

So you are ok with the government 'educating' the population on the law that grants them the right to own firearms and providing information about local gun shops? Obamacare is a law, but they are advancing the policy by the fact that they are encouraging people to sign up for private health insurance rather than simply informing them that the law has passed and its effects...

We don't teach the second amendment in grade school anymore? We produce IRS circulars explaining the tax forms. We have PSAs inviting young folks to join the military and urging people to get vaccinated for free and about heating subsidies. By which I mean, what are you talking about?

Considering that there is a very legitimate economic argument to be made in favor of educating people and getting them to enroll in health insurance through the exchanges, and as such any reasonable amount of money that is used to advocate the policy is an investment, I'd say the government is NOT doing enough to promote the insurance marketplace.

Some years ago I was in London and attended a Chelsea home game during the reign of Avram Grant as manager. The game itself was drab and forgettable, and the fans grew frustrated with Chelsea's tactics and performance as the afternoon progressed.

But what stuck in my memory was that in the second half a chant from the fans started, intermittently at first but then louder and unmistakably gathering steam, until at one point it seemed the entire stadium was shouting at Grant:

Increasingly it is becoming clear that the people in charge of Obamacare have no idea what they are doing and are making it up as they go along. Healthcare is a huge chunk of the US economy, there is no plan, and these people are absolutely clueless.

The only reason enrollment by the young is so sought after is because the program makes no economic sense for them - but the premiums they are asked to pay represent a rich source of ACA-profits that can be redirected to the benefit of other segments of society.

Encouraging in a way to see that the young are smart enough to resist being played for chumps, isn't it? And fair too - the young are, after all, the poorest demographic in society; they should be the last people to be asked to subsidize others, not the first.

There remain millions of uninsured Americans who could buy coverage, but they seem unconvinced that Obamacare will help them.
.
Then again, the problem may not be that they are unconvinced. It may just be that they find fighting their way thru the system too difficult. I have used the California version to get insurance for my wife. I started wrestling with it in November, and only just now finished getting everything in place. The biggest problems:
1) The site not being up and working. This not only impacted me when I tried to do things. It was also a problem when I was on the phone with the Support Center -- because they couldn't do things due to the system being unavailable.
2) The directions being obscure. Sometimes I couldn't do something sinmply because I couldn't figure out what they wanted. Worse, when I guessed and guessed wrong, correction was diffecult. (Which is why I was on the phone with the Support Center in the first place.)
3) If you need help, the Support Center phone line wait times range from 20 minutes (at 8:01 AM, just seconds after they start taking calls for the day) to well over an hour. How do-able is that if you are trying to call from work? But because the Support Center is not available 24/7, calling from work is probably what you want to do.
.
And note that, for those first two issues, I've been dealing with IT for decades. It's not like it's a foreign land I am trying to navigate thruough -- unlike a lot of the uninsured that the program is trying to reach.
.
I understand that those in charge are concerned about reaching out to those that haven't enrolled. But they really should think seriously about what they could do to make enrollment easier . . . or even possible.

Yaah. The healthcare.gov website was a mess. A friend of mine tried to sign up in November 2013 and he was asked to provide income proof for 2014 and document proving that he was not an inmate at a prison.

Some heads at HHS should have had rolled for this botched website and its implementation and how it made people fill up extensive forms and such stupid documentation without even getting to browse the plans available.

But this wasn't even the healthcare.gov website. (Which also has lots of problems, albeit partly for different reasons.) This was the coveredca.gov website, which only deals with California plans.
.
And, as I didn't mention, it also persists in saying that it "cannot confirm your SSN" -- which presumably means that the connection to the IRS is messed up. Because, at least in our cases, we are using our own valid and long-established SSNs. But apparently they need a copy of or Social Security cards faxed to them. Like that's any kind of secure and unforgeable proof.

It seems to be a relatively simple task. Person fills in demographic data. Said data is matched with database. Person picks the plan they want. Said data is forwarded to insurance company. It seems less complicated than say, tracking a package from me to you.

I don't understand why they just didn't go to Amazon, or B of A, UPS or someone else who handles millions of secure transactions per day, and lease their expertise.

The critical question, unanswered here, is what portion of those previously uninsured people who have enrolled were uninsurable under the pre-existing system? The selection bias here is likely hugely skewed toward those who have a strong need for coverage.

This is generally good for providing affordable health care to those who need it most, but generally bad for funding the overall system. If more people are drawing more use from the overall health care system but paying a very limited amount into it, that by definition raises costs for everybody else.